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Multidimensional Adaptive Testing for Mental Health Problems in Primary Care

William Gardner, Kelly J. Kelleher, Kathleen A. Pajer
2002 Medical Care  
Sites and Settings All clinicians participating in the Child Behavior Study (PI: Kelleher, MH 50629) were included for this research (401 clinicians in 44 states, the Commonwealth of Puerto Rico, and four  ... 
doi:10.1097/00005650-200209000-00010 pmid:12218771 fatcat:hx7vtgz4xbhutbdggqp2nxqsga

Computerized adaptive measurement of depression: A simulation study

William Gardner, Katherine Shear, Kelly J Kelleher, Kathleen A Pajer, Oommen Mammen, Daniel Buysse, Ellen Frank
2004 BMC Psychiatry  
Efficient, accurate instruments for measuring depression are increasingly important in clinical practice. We developed a computerized adaptive version of the Beck Depression Inventory (BDI). We examined its efficiency and its usefulness in identifying Major Depressive Episodes (MDE) and in measuring depression severity. Methods: Subjects were 744 participants in research studies in which each subject completed both the BDI and the SCID. In addition, 285 patients completed the Hamilton
more » ... Rating Scale. Results: The adaptive BDI had an AUC as an indicator of a SCID diagnosis of MDE of 88%, equivalent to the full BDI. The adaptive BDI asked fewer questions than the full BDI (5.6 versus 21 items). The adaptive latent depression score correlated r = .92 with the BDI total score and the latent depression score correlated more highly with the Hamilton (r = .74) than the BDI total score did (r = .70). Conclusions: Adaptive testing for depression may provide greatly increased efficiency without loss of accuracy in identifying MDE or in measuring depression severity.
doi:10.1186/1471-244x-4-13 pmid:15132755 pmcid:PMC416483 fatcat:yzoyvw54snarlf2q4jt4qz3fxm

Primary Care Clinicians' Use of Standardized Tools to Assess Child Psychosocial Problems

William Gardner, Kelly J. Kelleher, Kathleen A. Pajer, John V. Campo
2003 Ambulatory Pediatrics  
and Objectives.-Children's psychosocial problems are prevalent but often inaccurately diagnosed. This study investigated primary care clinicians' (PCCs) use of standardized tools for psychosocial problems among children in whom they reported finding a problem. Methods.-The data consisted of 21 065 unique visits by children ages 4 to 15 years in 204 practices. Parents completed questionnaires before seeing the PCCs, who completed a survey after the visit. This analysis included 3934 children who
more » ... were recognized by PCCs as having one or more psychosocial problems. The primary outcome was the PCCs' usage of a tool to assess child psychosocial problems. Results.-PCCs used a tool in 20.2% of visits where a psychosocial problem was recognized, whereas 50% of PCCs never used such tools. Tools were less likely to be used by female PCCs and family practitioners and were less likely to be used with girls and African American children. Tools were more frequently used with children with attention problems, during visits for psychosocial problems, and when the PCC knew about the problem before the visits. Conclusions.-PCCs use standardized tools infrequently to screen for, confirm, or monitor psychosocial problems.
doi:10.1367/1539-4409(2003)003<0191:pccuos>2.0.co;2 pmid:12882596 fatcat:vja64ech5zawxhp4wfsa4rswdu

Medicaid Insurance Policy for Youths Involved in the Criminal Justice System

Alison Evans Cuellar, Kelly J. Kelleher, Jennifer A. Rolls, Kathleen Pajer
2005 American Journal of Public Health  
Kelleher, MD, MPH, Jennifer A.  ...  Rolls, MPH, and Kathleen Pajer, MD, MPH Am J Public Health. 2005;95:1707-1711. doi:10. 2105/AJPH.2004.056259) TABLE 2 - 2 Expressed Beliefs of State and Community Juvenile Justice and Medicaid Agencies  ...  Kelleher conceived of the ADAM survey and oversaw all aspects of its implementation. J. A. Rolls oversaw data collection for the study and assisted in interpreting the findings. K.  ... 
doi:10.2105/ajph.2004.056259 pmid:16131641 pmcid:PMC1449424 fatcat:6dyamligdrdbbfwsfy2ieyuw3m

Follow-up care of children identified with ADHD by primary care clinicians: A prospective cohort study

William Gardner, Kelly J. Kelleher, Kathleen Pajer, John V. Campo
2004 Journal of Pediatrics  
Objective To document follow-up care received by children identified with attention deficit hyperactivity disorder (ADHD) by primary care clinicians (PCCs). Study design We surveyed families of children 4 to 15 years of age who had been diagnosed with ADHD. At an index office visit, parents and clinicians completed questionnaires. Six months after the index visit, parents completed a questionnaire (N = 659 returned surveys, 68% return rate). The main outcome measure was the number of visits
more » ... the patients' PCCs or mental health specialists during the 6 months after the index visit. Results Children had a median of one visit PCC over a period of 6 months. Children who had prescriptions for psychotropic medications (78%) did not differ from others in the number of visits. Follow-up visits with the child's own doctor were more common when the PCC had completed mental health training. Only 26% of patients saw a mental health specialist. Children who were black, on Medicaid, or with higher levels of internalizing symptoms were more likely to see a mental health specialist. Conclusions Children treated for ADHD need more follow-up visits to permit adjustment of medication and support continuation of patients in treatment. Systematic quality improvement efforts are warranted. (
doi:10.1016/j.jpeds.2004.08.028 pmid:15580198 fatcat:76mpq3esfrfszf55g7rixe5uny

Child Sex Differences in Primary Care Clinicians' Mental Health Care of Children and Adolescents

William Gardner, Kathleen A. Pajer, Kelly J. Kelleher, Sarah Hudson Scholle, Richard C. Wasserman
2002 Archives of Pediatrics & Adolescent Medicine  
Sex differences in the medical and mental health care of adults are well established. Objective: To study the effect of child patient's sex on whether primary care clinicians (PCCs), including pediatricians, family physicians, and nurse practitioners, found or treated mental health problems in primary care settings. Design: The data were collected by clinicians and parents from 21065 individual child visits (50.3% girls) in 204 primary care practices. Methods: Each PCC enrolled a consecutive
more » ... ple of approximately 55 children and adolescents aged 4 to 15 years. Parents filled out questionnaires, including the Pediatric Symptom Checklist, before seeing the clinician. Clinicians completed a survey after the visit about the psychosocial problems and recommended treatments, but they did not see the results of the Pediatric Symptom Checklist or any other data collected from the parents. Results: Boys were more likely to be seen for a mental health-related visit and by a clinician who identified them as "my patient." Boys with parent-reported symptom profiles that were similar to those of girls were more likely to be identified as having attention-deficit/hyperactivity problems or behavior or conduct problems and less likely to be identified as having internalizing problems. Adjusting for parent-reported symptoms, PCCs were more likely to prescribe medications for boys. Child sex differences in referrals to mental health specialists and the provision of counseling to families were not statistically significant. Conclusion: There are substantial sex differences in the mental health care of children in the primary care system.
doi:10.1001/archpedi.156.5.454 pmid:11980550 fatcat:7yar3s3elvbafgzhu3x3ethnkm

Psychiatric and Medical Health Care Policies in Juvenile Detention Facilities

KATHLEEN A. PAJER, KELLY KELLEHER, RAVINDRA A. GUPTA, JENNIFER ROLLS, WILLIAM GARDNER
2007 Journal of the American Academy of Child and Adolescent Psychiatry  
Objectives: Many adolescents admitted to detention facilities have serious mental and physical health problems. Little is known about policies for the delivery of mental and physical health care in these settings. Our objective was to describe current health care policies in U.S. detention facilities. Method: Telephone interviews were requested from 83 juvenile detention facility administrators across the United States. Results: The response rate was 97.6%. Data were collected over 12 months,
more » ... om 2003Y2004. Policies for admission health screening existed in 99% of facilities; 90% included mental health screening. Most sites had policies about psychopharmacotherapy and 92% had crisis services. Continuation of existing psychotropic medication treatment was provided at 96% of facilities. Seventy-three percent of facilities used physicians to manage medications in-house; in 61% of the centers, these physicians were psychiatrists. Medication administration policies most often specified nurses, but 16% of facilities used guards. Provisions for discharge psychotropic medication existed at 84% of sites, but there was wide variation in dispensing policies. Conclusions: Detention health care policies for adolescents have significant gaps, particularly for mental health care. Future research should include an epidemiological study of detained youths, evaluating their health needs and the actual care received.
doi:10.1097/chi.0b013e318157d2da pmid:18030088 fatcat:huafhzetefgw3aydg7szr4j4hi

Weight loss with mindful eating in African American women following treatment for breast cancer: a longitudinal study

SeonYoon Chung, Shijun Zhu, Erika Friedmann, Catherine Kelleher, Adriane Kozlovsky, Karen W. Macfarlane, Katherine H. R. Tkaczuk, Alice S. Ryan, Kathleen A. Griffith
2015 Supportive Care in Cancer  
Purpose-Women with higher body mass index (BMI) following breast cancer (BC) treatment are at higher risk of BC recurrence and death than women of normal weight. African American (AA) BC patients have the highest risk of BC recurrence and gain more weight after diagnosis than their white counterparts. The purpose of this study was to evaluate the association between a mindful eating intervention and weight loss in AA women following chemotherapy for BC. Methods-A single-group 24-week
more » ... l pilot study with repeated measures was conducted. AA women (N= 22, BMI=35.13 kg/m 2 , range=27.08-47.21) with stage I-III BC who had finished active cancer treatment received a 12-week mindful eating intervention with individual dietary counseling and group mindfulness sessions, followed by bi-weekly telephone follow-up for 12 weeks. Linear mixed models were used to evaluate the effects of the intervention and of baseline mindfulness on the weight change over time. Results-In the overall group (N=22), MEQ scores increased over time (p=0.001) while weight decreased over time (−0.887 kg, p=0.015). Weight loss over time was associated with higher T1 MEQ scores (p=0.043). Participants in the higher MEQ group (n=11) at T1 experienced significant weight loss over time (−1.166 kg, p=0.044), whereas those in the low MEQ (n=11) did not lose
doi:10.1007/s00520-015-2984-2 pmid:26463645 pmcid:PMC4909150 fatcat:geuvrektpzagtdlkgwich2m55m

Discovery of conformation-sensitive anti-amyloid protofibril monoclonal antibodies using an engineered chaperone-like amyloid-binding protein [article]

W Vallen Graham, Alessandra Bonito-Oliva, Rita Agostinelli, Riyaz Karim, Jeremy Deguzman, Kerry Kelleher, Marianne Petro, Anna-Karin Lindstrom, Caroline Graff, Kathleen M. Wood, Lioudmila Tchistiakova, Kimberly Marquette (+2 others)
2019 bioRxiv   pre-print
The hypothesis that amyloid beta peptides (Aβ) are central to the pathogenesis of sporadic Alzheimer's disease (AD) is still hotly debated. Although several monoclonal antibodies (mAbs) against Aβ have failed in therapeutic clinical trials, two conformation-selective, anti-Aβ mAbs continue to show promise. A significant challenge has been to discover mAbs that preferentially target Aβ protofibrils over natively-folded monomeric peptides or amyloid plaques. We have engineered a novel
more » ... ke amyloid-binding protein (CLABP), Nucleobindin 1 (NUCB1), which enables the stabilization of protofibrils, allowing them to be used as immunogens in mice to facilitate the generation of mAbs that recognize Aβ protofibrils. An immunization campaign and subsequent screening funnel identified a panel of mAbs with high-affinity to Aβ. Two mAbs in particular, 1A8 and 7C8, displayed significant conformation sensitivity and preferentially bound Aβ protofibrils over monomers. Furthermore, 1A8 delayed Aβ aggregation, but did not prevent eventual fibril formation, while 7C8 significantly and dose-dependently reduced fibril formation by inhibiting both primary and secondary nucleation. Both mAbs protected against protofibril-induced cytotoxicity in vitro, and showed distinctive staining patterns by immunohistochemistry in PS1/APP mice and in post-mortem AD brain tissue. In summary, we describe a novel method to stabilize soluble Aβ protofibrils for use in immunization campaigns. We hypothesize that the stabilized protofibrils retain the neoepitopes of the Aβ protofibril and the aggregates found in mouse models of disease and post-mortem AD brain tissue.
doi:10.1101/558809 fatcat:iqzmfexdp5e6nk3ka2iq5sfspu

Trends in antiretroviral treatment use and treatment response in three Australian states in the first decade of combination antiretroviral treatment

Kathleen Falster, Linda Gelgor, Ansari Shaik, Iryna Zablotska, Garrett Prestage, Jeffrey Grierson, Rachel Thorpe, Marian Pitts, Jonathan Anderson, John Chuah, Brian Mulhall, Kathy Petoumenos (+2 others)
2008 Sexual Health  
Objectives-To determine if there were any differences in antiretroviral treatment (ART) use across the three eastern states of Australia, New South Wales, Victoria and Queensland, during the period 1997 to 2006. Methods-We used data from a clinic-based cohort, the Australian HIV Observational Database (AHOD), to determine the proportion of HIV-infected patients on ART in selected clinics in each state and the proportion of treated patients with an undetectable viral load. Data from the national
more » ... Highly Specialised Drugs program and AHOD was used to estimate total numbers of individuals on ART and the proportion of individuals living with HIV on ART nationally and by state. Data from the HIV Futures Survey and the Gay Community Periodic Survey (GCPS) were used to determine the proportion of community-based men who have sex with men (MSM) on ART. The proportion of patients with primary HIV infection (PHI) who commenced ART within one year of diagnosis was obtained from the Acute Infection and Early Disease Research Program (AIEDRP) CORE01 protocol and Primary HIV and Early Disease Research: Australian cohort (PHAEDRA) cohorts. Results-We estimated that the numbers of individuals on ART increased from 3,181 to 4,553 in NSW, 1,309 to 1,926 in Victoria and 809 to 1615 in Queensland between compared to the other states (37% compared to 49 and 55% in 2000). We found similar proportions of HIV-positive MSM participants were on ART in all three states over the study period in the clinicbased AHOD cohort (81-92%) and two large, community based surveys in Australia (69-85% and 49-83%) . Similar proportions of treated patients had an undetectable viral load across the three states, with a consistently increasing trend over time observed in all states. We found that more PHI patients commenced treatment in the first year following HIV diagnosis in NSW compared to Victoria; however, the sample size was very small. Conclusions-For the most part, patterns of ART use were similar across NSW, Victoria and Queensland using a range of available data from cohort studies, community surveys and national prescription databases in Australia. However, there may be a lower proportion of individuals living with HIV on ART in NSW compared to the other states, and there is some indication of a more aggressive treatment approach with PHI patients in NSW compared to Victoria.
doi:10.1071/sh07082 pmid:18588779 pmcid:PMC2742671 fatcat:sh7qv6ebebdgfcwpocaekmgtpu

High CD26 and Low CD94 Expression Identifies an IL-23 Responsive Vδ2+ T Cell Subset with a MAIT Cell-like Transcriptional Profile

Kathleen M. Wragg, Hyon-Xhi Tan, Anne B. Kristensen, Catriona V. Nguyen-Robertson, Anthony D. Kelleher, Matthew S. Parsons, Adam K. Wheatley, Stuart P. Berzins, Daniel G. Pellicci, Stephen J. Kent, Jennifer A. Juno
2020 Cell Reports  
Vδ2+ T cells play a critical role in immunity to micro-organisms and cancer but exhibit substantial heterogeneity in humans. Here, we demonstrate that CD26 and CD94 define transcriptionally, phenotypically, and functionally distinct Vδ2+ T cell subsets. Despite distinct antigen specificities, CD26hiCD94lo Vδ2+ cells exhibit substantial similarities to CD26hi mucosal-associated invariant T (MAIT) cells, although CD26- Vδ2+ cells exhibit cytotoxic, effector-like profiles. At birth, the Vδ2+Vγ9+
more » ... pulation is dominated by CD26hiCD94lo cells; during adolescence and adulthood, Vδ2+ cells acquire CD94/NKG2A expression and the relative frequency of the CD26hiCD94lo subset declines. Critically, exposure of the CD26hiCD94lo subset to phosphoantigen in the context of interleukin-23 (IL-23) and CD26 engagement drives the acquisition of a cytotoxic program and concurrent loss of the MAIT cell-like phenotype. The ability to modulate the cytotoxic potential of CD26hiCD94lo Vδ2+ cells, combined with their adenosine-binding capacity, may make them ideal targets for immunotherapeutic expansion and adoptive transfer.
doi:10.1016/j.celrep.2020.107773 pmid:32553157 fatcat:tlwnxr64d5emjhdt5xn2prvcmq

Modulation of the CCR5 receptor/ligand axis by seminal plasma and the utility of in vitro versus in vivo models

Jennifer A Juno, Kathleen M Wragg, Anne B Kristensen, Wen Shi Lee, Kevin J Selva, Renee M van der Sluis, Anthony D Kelleher, Benjamin R Bavinton, Andrew E Grulich, Sharon R Lewin, Stephen J Kent, Matthew S Parsons
2019 Journal of Virology  
Sexual HIV-1 transmission occurs primarily in the presence of semen. Although data from macaque studies suggests CCR5+CD4+ T cells are initial targets for HIV-1 infection, the impact of semen on T cell CCR5 expression and ligand production remains inconclusive. To determine if semen modulates the lymphocyte CCR5 receptor/ligand axis, primary human T cell CCR5 expression and natural killer (NK) cell anti-HIV-1 antibody-dependent beta chemokine production was assessed following seminal plasma
more » ... exposure. Purified T cells produce sufficient quantities of RANTES to result in a significant decline in CCR5bright T cell frequency following 16 hours of SP exposure (p=0.03). Meanwhile NK cells retain the capacity to produce limited amounts of MIP-1α/MIP-1β in response to anti-HIV-1 antibody-dependent stimulation (median 9.5% MIP-1α+MIP-1β+), despite the immunosuppressive nature of SP. Although these in vitro experiments suggest that SP-induced CCR5 ligand production results in the loss of surface CCR5 expression on CD4+ T cells, the in vivo implications are unclear. We therefore vaginally exposed five pigtail macaques to SP and found that such exposure resulted in an increase in CCR5+ HIV-1 target cells in three out of five animals. The in vivo data support a growing body of evidence suggesting that semen exposure recruits target cells to the vagina that are highly susceptible to HIV-1 infection, which has important implications for HIV-1 transmission and vaccine design. IMPORTANCE The majority of HIV-1 vaccine studies do not take into consideration the impact that semen exposure might have on the mucosal immune system. In this study, we demonstrate that seminal plasma (SP) exposure can alter CCR5 expression on T cells. Importantly, in vitro studies of T cells in culture cannot replicate the conditions under which immune cells might be recruited to the genital mucosa in vivo, leading to potentially erroneous conclusions about the impact of semen on mucosal HIV-1 susceptibility.
doi:10.1128/jvi.00242-19 pmid:30867307 pmcid:PMC6532071 fatcat:bcn44ekk65cjjmyrwbgjtkt3le

Cassini RADAR observations of Enceladus, Tethys, Dione, Rhea, Iapetus, Hyperion, and Phoebe

Steven J. Ostro, Richard D. West, Michael A. Janssen, Ralph D. Lorenz, Howard A. Zebker, Gregory J. Black, Jonathan I. Lunine, Lauren C. Wye, Rosaly M. Lopes, Stephen D. Wall, Charles Elachi, Laci Roth (+7 others)
2006 Icarus (New York, N.Y. 1962)  
Cassini 2.2-cm radar and radiometric observations of seven of Saturn's icy satellites yield properties that apparently are dominated by subsurface volume scattering and are similar to those of the icy Galilean satellites. Average radar albedos decrease in the order Enceladus/Tethys, Hyperion, Rhea, Dione, Iapetus, and Phoebe. This sequence most likely corresponds to increasing contamination of near-surface water ice, which is intrinsically very transparent at radio wavelengths. Plausible
more » ... tes for contaminants include ammonia, silicates, metallic oxides, and polar organics (ranging from nitriles like HCN to complex tholins). There is correlation of our targets' radar and optical albedos, probably due to variations in the concentration of optically dark contaminants in near-surface water ice and the resulting variable attenuation of the high-order multiple scattering responsible for high radar albedos. Our highest radar albedos, for Enceladus and Tethys, probably require that at least the uppermost one to several decimeters of the surface be extremely clean water ice regolith that is structurally complex (i.e., mature) enough for there to be high-order multiple scattering within it. At the other extreme, Phoebe has an asteroidal radar reflectivity that may be due to a combination of single and volume scattering. Iapetus' 2.2-cm radar albedo is dramatically higher on the optically bright trailing side than the optically dark leading side, whereas 13-cm results reported by Black et al. [Black, G.J., Campbell, D.B., Carter, L.M., Ostro, S.J., 2004. Science 304, 553] show hardly any hemispheric asymmetry and give a mean radar reflectivity several times lower than the reflectivity measured at 2.2 cm. These Iapetus results are understandable if ammonia is much less abundant on both sides within the upper one to several decimeters than at greater depths, and if the leading side's optically dark contaminant is present to depths of at least one to several decimeters. As argued by Lanzerotti et al. ], a combination of ion erosion and micrometeoroid gardening may have depleted ammonia from the surfaces of Saturn's icy satellites. Given the hypersensitivity of water ice's absorption length to ammonia concentration, an increase in ammonia with depth could allow efficient 2.2-cm scattering from within the top one to several decimeters while attenuating 13-cm echoes, which would require a six-fold thicker scattering layer. If so, we would expect each of the icy satellites' average radar albedos to be higher at 2.2 cm than at 13 cm, as is the case so far with Rhea [Black, G., Campbell, D., 2004. Bull. Am. Astron. Soc. 36, 1123 as well as Iapetus.
doi:10.1016/j.icarus.2006.02.019 fatcat:aotpacumqzgwbkk5geh46nq3hi

Page 1683 of Psychological Abstracts Vol. 89, Issue 4 [page]

2002 Psychological Abstracts  
J., 9971 Keil, Andreas, 10198 Keim, Jeanmarie, 9695, 12435 Keita, Gwendolyn, 12301 Kelemen, Oguz, 11166 Kelleher, C., 10595 Kelleher, Kevin, 11308 Kelleher, Margaret, 12217 Kelleher, Michael D., 12780  ...  ., 11688 Kawahara, Jun-ichiro, 9954 Kawai, Kensuke, 11576 Kawakatsu, Shinobu, 11900 Kawamura, Kathleen Y., 10542 Kaye, Lenard W., 12193 Kaysen, Debra, 10594 Kazennikov, Oleg, 11656 Keaser , Michael C.  ... 

The Place of Performance – Editorial

Sophie Berrebi, Hendrik Folkerts
2015 Stedelijk studies  
A number of authors look at disciplinary traditions and questions of display, such as Joe Kelleher and Kirsten Maar, or political articulations,  ...  Some authors examine queer and/or feminist positions: Amelia Jones, Robin Kathleen Williams, Paul B. Preciado, Arnisa Zeqo, Miguel A. López, and Giuseppe Campuzano.  ...  Many articles are concerned with documentation and the document and, in some cases, the objecthood of performance: Massa Lemu, Robin Kathleen Williams, Stephanie Sparling Williams, Barbara Büscher, and  ... 
doi:10.54533/stedstud.vol003.art01 fatcat:emx7k56xwzaalogcgoau3p7ldy
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